| 42 North Dental Care, Llc | |
|
368a W Broadway # A South Boston MA 02127-2215 | |
| (617) 269-0004 | |
| Not Available |
| Full Name | 42 North Dental Care, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 368a W Broadway # A, South Boston, Massachusetts |
| Authorized Official Name and Position | Michael Angelo Scialabba (CHIEF CLINICAL OFFICER) |
| Authorized Official Contact | 5615122709 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 42 North Dental Care, Llc 200 5th Ave Fl 3 Waltham MA 02451-8759 Ph: (781) 647-0772 | 42 North Dental Care, Llc 368a W Broadway # A South Boston MA 02127-2215 Ph: (617) 269-0004 |
| NPI Number | 1346519006 |
|---|---|
| Provider Enumeration Date | 12/23/2011 |
| Last Update Date | 06/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346519006 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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